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Individual

CORRIE SHORT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
17201 SE 21ST ST, VANCOUVER, WA 98683-3304
(360) 907-5487
Mailing address
17201 SE 21ST ST, VANCOUVER, WA 98683-3304
(360) 907-5487

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP60536017
WA
101YM0800X
Mental Health Counselor
Primary
LH61427204
WA
101YM0800X
Mental Health Counselor

Other

Enumeration date
04/21/2014
Last updated
08/10/2024
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